Homestead_Overton (3)�, CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
/ State Form Sd73 (R6 / /-03)
Presriibed by the Department of Lotal Govemment Finance
INSTRUCTIONS: See revcisc side lor liling ins6ucfions.
FORM
HC10
�.--y 'i ^n
YEAR
� M'e) � I�.0 "V� �9--� (�/ 3�.07S��r�. ) ceniry tnatv� `7e 15 j�P`h�arcn. 20
I(We,yoccupied as our principal place oi residence Ihe (ollowing descnbed real property for which a Homestead Propehy aiCr i s reby daimed:
� 1(We) owned ❑ Are buying under contract � � , ,- ,-
, Have a benefidal interest in the enGry Mat is liable for Ne pmperty taxes on the property and �hat owns ihe'p�ope or isbuying under a wnVact.
' GIB�ON C'_��-
If buying on conUad, Fee Simpie ownefs name
Recorders ofice where mnVad is
County
Parcel number
Tamship
Legal description
(��-007��'`� �
1/ any portian o/ the residenUal structure a the land na eacee
of ihe property uliGzed to produce�
� �w
County
Township
Record number � Page
T�ing tlistrict (ciry, rown. fownshiP)
I Is Ihe Property in lion:
u e� v��vem ❑ nwwie Homo ��.c. �,.,-n
one (t) acre tAat immeCiatery wrrounds �hat sWcture is usetl to produce income, desaibe the use and portbn
ay_ 3-�/
I hereby ceAi(y the above statements are We, correct and complete.
ACtlress (number aM sfreet, city, sfata, ZlPCOde)
Uo?S�
County
�
�
�� a^td,2�j7'�� • "'� .'. �d' F �� .. . . . 4>. ni c�•r.�
y��'+�� ��ASSESSOR�USEONLY�-4-Z��; ��"'r''��TRUET���� ASSESSED�VALUE r HOMESTEAD"�' NON'-,�RESIDENTIAL �7,
�_e�;r� . ;�_�vs,�p� a�gt;��n wry:��,� j �VALUE��..�t;� . �AT 100YawOF�TTViy. ��VALUE� ����C�..��FVALUE _�;-� ��.
Land not exceeding 1(one) acre immediately ;�� "X?�s?.�.�.-��z-��` 3�
suvounding residenUal improvements. (� � � ���y.y.���.`,-.�'�` �
Fa .�3�`
Otherland . �Z� =�� ���
s �' ~ 2��:_:�?
��2:_
Tdal land (line 7 plus line 2) (g�
��r"�"}����q��'�� �'�`'�{
Dwelling (4) ���+#4� �_-��g7d'���
Residentiel improvements or Mnualty "'
Asse�edMobile/ManufacWredHmie y�x �n'�, ..,w��
Garage (5) �a�a��y' �' �. �'
�.�-
Other improvements (6) ry��~��
:�.�'� y
Tdat improvemenls (line 4 through line 6) (7)
7Ua1 value (line 3 phs line 7) �g�
I hereby certify �he aboVe is We, corred, and Signature of Assessor Date signed
complele.
Vai(yiig action - Signature of Auditor Date signed
�.. .-..-.:•>-�- L -
`. _. ��4`�'�%� + _f�r�,''�a.-�e.rczT�'�'t :�.;3� STANDARU:UEDUCTION'ALCOWAMCE. �.3`�i?k`ky.'iX��='.`"��'n�"r`-"�"',�' a.�.z'�'A. . "-;,.:.
....,��
2 Pay 20 _
Lesser of 1/2 Homestead g
vauauon or E35.W0
Sg atur fAUditw ' , /] Dalesigned
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